The following article features coverage from the 2021 Genitourinary Cancers Symposium meeting. Click here to read more of Oncology Nurse Advisor‘s conference coverage.

In a recent study, Black race and female sex appeared to be predictors of delayed diagnosis of urothelial cell carcinoma of the bladder, and disparities were noted regarding treatment across stages. The study findings were presented at the American Society of Clinical Oncology 2021 Genitourinary Cancers Symposium.

The study examined demographic characteristics in relation to diagnosis and treatment of urothelial cell carcinoma of the bladder. The research team collected data from the National Cancer Database and stratified patient cases by cancer stage. Stages were categorized as early (Ta, Tis, T1 stage groupings), muscle invasive (T2-3, N0), locally advanced (T4, N1-3), and metastatic.

Most cases (331,714) were categorized as early cancers, while 72,154 were muscle invasive, with 15,579 categorized as locally advanced, and 15,161 categorized as metastatic. Using multivariate statistics, the researchers identified several demographic characteristics that were significant predictors of diagnosis beyond early-stage disease, the most substantial of which were Black race and female sex.

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For Black patients, relative to early-stage diagnosis, diagnosis at the muscle-invasive stage showed a hazard ratio (HR) of 1.19 (95% CI, 1.15-1.23). For diagnosis when the cancer was locally advanced, the HR was 1.49 (95% CI, 1.40-1.59), and for diagnosis when metastatic, the HR was 1.66 (95% CI, 1.56-1.76). Black race was also a strong predictor of a lack of receiving cancer-directed treatment across all stages.

For female patients, relative to early-stage diagnosis, diagnosis at the muscle-invasive stage had an HR of 1.21 (95% CI, 1.18-1.21); at the locally advanced stage, it was 1.16 (95% CI, 1.12-1.20); and when metastatic, it was 1.34 (95% CI, 1.29-1.38).

The researchers concluded that this study found demographic disparities related to both stage at diagnosis and use of cancer-directed treatments for patients with bladder cancer.

Disclosures: Some authors declared affiliations with or received funding from the pharmaceutical industry. Please refer to the original abstract for a full list of disclosures.

Read more of our coverage of the 2021 Genitourinary Cancers Symposium by visiting the conference page.


Hasan S, Lazarev S, Garg M, et al. Social disparities in the diagnosis and management of bladder cancer. J Clin Oncol. 2021;39(suppl 6):abstr 403. doi:10.1200/JCO.2021.39.6_suppl.403